Provider Demographics
NPI:1952965154
Name:CAREW, MATHEW DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:MATHEW
Middle Name:DAVID
Last Name:CAREW
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3613 RESERVE COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8179
Mailing Address - Country:US
Mailing Address - Phone:216-387-7690
Mailing Address - Fax:
Practice Address - Street 1:3613 RESERVE COMMONS DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8179
Practice Address - Country:US
Practice Address - Phone:216-387-7690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL090717900122300000X
390200000X
OH30.0267351223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDentist Anesthesiologist
No122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program